Q&A: How should diagnoses be listed on the UB-04 claim?

Billing and Reimbursement / MDS 3.0 and the RAI Process / NAC / Q&A

Question: I understand that the diagnosis in I0020B should be listed as the principal diagnosis on the UB-04 claim; however, should the remaining diagnoses be listed in order according to the main reasons the resident is skilled how we list the codes in I8000, to include the codes that are …

Q&A: When residents pass away at the facility and do not have a funeral home listed, how long (hours) are we able to keep the body?

DNS / Q&A

Question: This situation seems to be happening at my facility more and more. When residents pass away at the facility and do not have a funeral home listed, how long (hours) are we able to keep the body? I have family members who seem to think that they can call …

Q&A: Does the primary diagnosis that physical therapy and occupational therapy use need to match the primary ICD-10 code used by nursing?

Billing and Reimbursement / NAC / Q&A

Question: Does the primary diagnosis that physical therapy and occupational therapy use need to match the primary ICD-10 code used by nursing?     Answer: Often confusion stems from the terms used across different disciplines. Therapists use medical and treatment diagnoses, while the SNF uses other terms, such as admission diagnosis, …

Q&A: How will the 30-day window rule work under PDPM with the new Interrupted Stay Policy?

Billing and Reimbursement / NAC / Q&A

Question: Under RUG-IV PPS, if the resident returns to a skilled level of care within 30 days the reason for skilled care would have to be something that was present/treated during the first qualifying hospital stay or developed during the skilled period. How does that work with PDPM and the Interrupted …

Q&A: How should we code a resident who is independent with eating during the day, but is total dependence for nightly tube feeding?

NAC / Q&A

Question: We have a resident who is independent with eating during the day, but also is total dependence for nightly tube feeding.  Would a coding of extensive assist of one be correct?    Answer:  Please review the example in the RAI Manual on page G-11: Residents with tube feeding, TPN, …

Q&A: Do we need to report to ombudsman if a short-term resident was sent out to the hospital for change of condition?

Clinical Care Solutions / DNS / Q&A

Question: Do we need to report to ombudsman if a short-term resident was sent out to the hospital for change of condition? Answer: No, not unless the change of condition was due to an unusual occurrence. Interested in reading more FAQs? Visit the AADNS Network where you can review questions …

Q&A: Our facility is non-smoking. A small number of staff have a picnic table approximately 50 yards away from the facility where they are allowed to smoke. Do we still need a smoking policy?

DNS / Q&A / Survey and Regulatory Compliance

Q: Our facility is non-smoking.  A small number of staff have a picnic table approximately 50 yards away from the facility where they are allowed to smoke. We do not allow smoking within the facility and none of our residents smoke. That said, do we still need a “smoking policy?” …